You wake up and find your blood glucose levels as if you have been eating cookies the whole night. Sometimes Diabetes does not make a lot of sense. Such morning highs are common in people with Diabetes. But in fact, there are three reasons for this high morning sugar-
1. Dawn Phenomenon:
It is a natural rise in blood glucose during morning hours i.e. between 4.00 am to 8.00 am. This occurs due to hormonal changes in the body. Usually a non diabetic just secrete more insulin to overcome this rise in blood glucose. But for diabetics it becomes tough to handle, as they may not have enough insulin.
If you are on insulin you can adjust the dose in such a way that peak action occurs closer to morning rise in blood glucose.
2. Somogyi Effect:
When you experience Hypoglyceamia (due to excess insulin or not having enough food or alcohol consumption) during sleep, to encounter this low blood glucose body responds in a rigorous way and deploys hormone glucagon. This leads to rise in blood glucose, sometimes too much. But wouldn’t this low wake you up?? Not necessarily.
You can have a snack before going to bed or reduce your insulin dose at night.
3. Waning Insulin:
Sometimes your insulin just runs out or wears off. You do not have enough insulin and there is a rise in blood glucose. It becomes a matter for you and your doctor to adjust the dose of insulin accordingly. You can look at splitting your basal insulin or taking it at different times.
There are ways to overcome these conditions and make many happy mornings in a range. Before adjusting the diet plan and medications it is important to rule out the correct culprit among the three mentioned above. Here’s one simple method to rule out the culprit: check your blood glucose at bedtime, at 3.00 am and at the morning wake up time for at least three or more times in a row.
- If your blood glucose is fairly even between bedtime and 3.00 am, but then rises between 3.00 am and morning, chances are of Dawn phenomenon.
- If your blood glucose is normal at bedtime, low at 3.00 am but high in the morning then it’s likely to be Somogyi effect.
- If your blood glucose is higher at 3.00 am than at bedtime and higher still in the morning, your insulin is probably waning
If you are Diabetic, chances are you will experience the occasional high morning blood glucose. That’s not to be frightened of too much. But if it happens frequently, than it‘s time to consult your doctor. It may happen that your morning blood glucose is the highest of the day and remains consistently high for the rest of the day after that. It’s important to recognise that and adopt a strategy to control it.